From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.).
N Engl J Med. 2022 May 12;386(19):1804-1816. doi: 10.1056/NEJMoa2200797. Epub 2022 Mar 9.
Waning of vaccine protection against coronavirus disease 2019 (Covid-19) and the emergence of the omicron (or B.1.1.529) variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have led to expedited efforts to scale up booster vaccination. Protection conferred by booster doses of the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines in Qatar, as compared with protection conferred by the two-dose primary series, is unclear.
We conducted two matched retrospective cohort studies to assess the effectiveness of booster vaccination, as compared with that of a two-dose primary series alone, against symptomatic SARS-CoV-2 infection and Covid-19-related hospitalization and death during a large wave of omicron infections from December 19, 2021, through January 26, 2022. The association of booster status with infection was estimated with the use of Cox proportional-hazards regression models.
In a population of 2,239,193 persons who had received at least two doses of BNT162b2 or mRNA-1273 vaccine, those who had also received a booster were matched with persons who had not received a booster. Among the BNT162b2-vaccinated persons, the cumulative incidence of symptomatic omicron infection was 2.4% (95% confidence interval [CI], 2.3 to 2.5) in the booster cohort and 4.5% (95% CI, 4.3 to 4.6) in the nonbooster cohort after 35 days of follow-up. Booster effectiveness against symptomatic omicron infection, as compared with that of the primary series, was 49.4% (95% CI, 47.1 to 51.6). Booster effectiveness against Covid-19-related hospitalization and death due to omicron infection, as compared with the primary series, was 76.5% (95% CI, 55.9 to 87.5). BNT162b2 booster effectiveness against symptomatic infection with the delta (or B.1.617.2) variant, as compared with the primary series, was 86.1% (95% CI, 67.3 to 94.1). Among the mRNA-1273-vaccinated persons, the cumulative incidence of symptomatic omicron infection was 1.0% (95% CI, 0.9 to 1.2) in the booster cohort and 1.9% (95% CI, 1.8 to 2.1) in the nonbooster cohort after 35 days; booster effectiveness against symptomatic omicron infection, as compared with the primary series, was 47.3% (95% CI, 40.7 to 53.3). Few severe Covid-19 cases were noted in the mRNA-1273-vaccinated cohorts.
The messenger RNA (mRNA) boosters were highly effective against symptomatic delta infection, but they were less effective against symptomatic omicron infection. However, with both variants, mRNA boosters led to strong protection against Covid-19-related hospitalization and death. (Funded by Weill Cornell Medicine-Qatar and others.).
针对 2019 年冠状病毒病（COVID-19）疫苗保护作用的衰减以及严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）的奥密克戎（或 B.1.1.529）变体的出现，促使人们加快了扩大加强针接种的步伐。在卡塔尔，与两剂基础系列疫苗相比，BNT162b2（辉瑞-生物科技）和 mRNA-1273（莫德纳）疫苗的加强剂量提供的保护作用尚不清楚。
我们开展了两项匹配的回顾性队列研究，以评估加强针接种相对于两剂基础系列疫苗单独接种在奥密克戎感染大流行期间（2021 年 12 月 19 日至 2022 年 1 月 26 日）针对有症状的 SARS-CoV-2 感染以及与 COVID-19 相关的住院和死亡的有效性。使用 Cox 比例风险回归模型估计加强针接种状态与感染之间的关联。
在至少接种两剂 BNT162b2 或 mRNA-1273 疫苗的 2239193 名人群中，接种过加强针的人与未接种加强针的人进行了匹配。在 BNT162b2 接种者中，在接种加强针后 35 天，有症状的奥密克戎感染的累积发病率在加强针组为 2.4%（95%置信区间[CI]，2.3 至 2.5），在非加强针组为 4.5%（95%CI，4.3 至 4.6）。与基础系列相比，加强针针对有症状的奥密克戎感染的有效性为 49.4%（95%CI，47.1 至 51.6）。与基础系列相比，加强针针对因奥密克戎感染而导致的与 COVID-19 相关的住院和死亡的有效性为 76.5%（95%CI，55.9 至 87.5）。与基础系列相比，BNT162b2 加强针针对 delta（或 B.1.617.2）变体的有症状感染的有效性为 86.1%（95%CI，67.3 至 94.1）。在 mRNA-1273 接种者中，在接种加强针后 35 天，有症状的奥密克戎感染的累积发病率在加强针组为 1.0%（95%CI，0.9 至 1.2），在非加强针组为 1.9%（95%CI，1.8 至 2.1）；与基础系列相比，加强针针对有症状的奥密克戎感染的有效性为 47.3%（95%CI，40.7 至 53.3）。在 mRNA-1273 接种者中，很少有严重的 COVID-19 病例。
信使 RNA（mRNA）加强针针对 delta 感染具有高度有效性，但针对有症状的奥密克戎感染的有效性较低。然而，对于这两种变体，mRNA 加强针都能强烈预防与 COVID-19 相关的住院和死亡。（由威尔康奈尔医学院-Qatar 和其他机构资助）。
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